| Objective: This study was to determine the association between thedynamic changes of serum cTnI, serum CK-MB, ECG and the severity ofcraniocerebral injury and early prognosis.Methods:136acute craniocerebralinjury patients were diagnosed by CT and enrolled in the Neurosurgerydepartment of Luzhou Medical College between September2010and September2011.All of them were enrolled within1to6hours after trauma. All the patientswere evaluated by Glasgow Coma Scale within24hours after their enrollmentand were divided into three groups according to their GCS scores and primarycoma time.Group A of50cases(mild，13≤GCS≤15,the primary coma timewithin30minutes after trauma)；Group B of44cases(moderate，9≤GCS≤12, theprimary coma time between30minutes and six hours after trauma)；Group C of42cases(severe，3≤GCS≤8, the primary coma time for more than6hours，orconsciousness deterioration within24hours after trauma, the coma time formore than6hours).Fasting blood samples were obtained to measure the serumcTnI, serum CK-MB levels and ECG was also recorded respectively at the1st,3rd,5th,7th and10th day after enrollment. All the patients were evaluated byGlasgow Outcome Scale after treatment for three months and were divided intothree groups according to their GOS scores.Group GOS1to2of16cases（deathor persistent vegetative）,Group GOS3to4of34cases（disability）,Group GOS5of86cases（good prognosis）.So that we could study the abnormal chang ofserum cTnI,CK-MB,ECG in acute craniocerebral injury patients at different time point and the relationship between GOS and abnormal rates of cTnI，CK-MBand ECG Results:(1)The accumulative positive rates of serum cTnI were1.20%for group A,5.00%for group B,40.48%for group C. The comparison amongthree groups had statistical significance (P<0.05).Furthermore, the total positiverate of serum cTnI for group C was significantly higher than that for group Aand group B(p<0.01),so there was a close association between the positive rateof serum cTnI and the severity of head injury.(2)The total positive rates ofserum CK-MB were0.80%for group A,4.09%for group B,31.43%for groupC.The comparison among three groups also had statistical significance (P<0.05)and the total positive rate of serum CK-MB for group C was significantly higherthan that for group A and group B(p<0.01),so there also was a close associationbetween the positive rate of serum CK-MB and the severity of head injury.(3)The whole abnormal rates of ECG were1.20%for group A,5.00%for groupB,59.52%for group C and the abnormal rates were different among three groupssignificantly(P<0.01),so the abnormal rate of ECG was closely related to theseverity of head injury and.(4)There were total81patients followed withsecondary myocardial damage among136acute traumatic brain injury patientsand the accumulative incidence was11.91%. There were8patients followedwith secondary myocardial damage among94mild and moderate traumaticbrain injury patients (9≤GCS≤15) and the accumulative incidence was1.7%.However, the number in the42severe traumatic brain injury patients were73and the accumulative incidence was34.76%. The comparison between thetwo groups had statistical significance in the incidence of secondary myocardial damage (P<0.01).(5)The abnormal rates of serum cTnI, serum CK-MB, ECG forGroup GOS1to2were higher than that for Group GOS3to4and Group GOS5(P<0.05).The abnormal rates of serum cTnI, ECG for Group GOS3to4werehigher than that for Group GOS5(P<0.05). It suggested that the earlyabnormalities of serum cTnI, serum CK-MB and ECG in acute craniocerebralinjury patients were useful to evaluate the prognosis (6)Severe craniocerebralinjury patients were usually followed with secondary myocardial damage.Thepositive rate of serum cTnl, serum CK-MB and the abnormal rate of ECGincreased with the prolongation of the traumatic time, reaching a peak3to5days later, and decreased7days after trauma.Conclusion:(1)Severecraniocerebral injury patients were usually followed with the increase of serumcTnI, serum CK-MB and ECG abnormalities early.The abnormal rates werehigher3to5days after trauma,but which began to decrease7days after trauma(2) The positive rates of serum cTnI, serum CK-MB and ECG were closelyrelated to the severity of head injury and prognosis.The heavier of severity ofhead injury, the higher of the incidence of secondary myocardial injury.Thelower of GOS,the higher of positive rate of myocardial injury markers andabnormal rate of ECG.(3)we should detect the serum cTnI, serum CK-MB andECG for acute craniocerebral injury patients, especially the severecraniocerebral injury patients, so that we can evaluate cardiac functionearly,which is beneficial to the patients，recovery. |
